PMID- 35959698
OWN - NLM
STAT- Publisher
LR  - 20240216
IS  - 1472-1465 (Electronic)
IS  - 0007-1250 (Linking)
DP  - 2022 Aug 12
TI  - Safety of psychological interventions for adult post-traumatic stress disorder: 
      meta-analysis on the incidence and relative risk of deterioration, adverse events 
      and serious adverse events.
PG  - 1-10
LID - 10.1192/bjp.2022.111 [doi]
AB  - BACKGROUND: Attention on harmful effects of psychological interventions for adult 
      post-traumatic stress disorder (PTSD) has increased, yet a comprehensive 
      meta-analysis is lacking. AIMS: To summarise incidences and relative risks of 
      deterioration, adverse events (AEs) and serious adverse events (SAEs) in trials 
      of psychological interventions for adult PTSD. METHOD: We searched MEDLINE, 
      PsycInfo, Web of Science and PTSDpubs from inception to 21 April 2022 for 
      sufficiently large (n >/= 20) randomised controlled trials (RCTs) reporting on the 
      incidence of harms. RESULTS: We included 56 RCTs (4230 patients). Incidences of 
      harms were generally low (0-5%). Psychological interventions were associated with 
      decreased risk of deterioration relative to passive (RR = 0.21, 95% CI 0.15-0.28) 
      and active control conditions (RR = 0.36, 95% CI 0.14-0.92). Decreased risk was 
      even more pronounced in sensitivity analyses on trials exclusively delivering 
      treatments face to face. When compared with other psychological interventions, 
      trauma-focused cognitive-behavioural therapy (TF-CBT) was associated with 
      decreased risk of SAEs (RR = 0.54, 95% CI 0.31-0.95) and with no differential 
      risk of deterioration and AEs. CONCLUSIONS: The current evidence base suggests 
      that psychological interventions are safe for most adults with PTSD. In none of 
      the analyses were psychological interventions associated with an increased risk 
      of harm compared with control conditions. TF-CBT was found at least as safe as 
      other psychological interventions. Individual face-to-face delivery might be the 
      safest delivery format. However, more data are needed to draw firmer conclusions. 
      We encourage research teams to routinely and thoroughly assess and report the 
      incidence of harms and their causes.
FAU - Hoppen, Thole H
AU  - Hoppen TH
AUID- ORCID: 0000-0002-6050-8696
AD  - Institute of Psychology, University of Munster, Germany.
FAU - Lindemann, Anna S
AU  - Lindemann AS
AD  - Institute of Psychology, University of Munster, Germany.
FAU - Morina, Nexhmedin
AU  - Morina N
AUID- ORCID: 0000-0002-2331-9140
AD  - Institute of Psychology, University of Munster, Germany.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220812
PL  - England
TA  - Br J Psychiatry
JT  - The British journal of psychiatry : the journal of mental science
JID - 0342367
SB  - IM
OTO - NOTNLM
OT  - PTSD
OT  - adverse event
OT  - deterioration
OT  - harm
OT  - psychological intervention
EDAT- 2022/08/13 06:00
MHDA- 2022/08/13 06:00
CRDT- 2022/08/12 05:13
PHST- 2022/08/12 05:13 [entrez]
PHST- 2022/08/13 06:00 [pubmed]
PHST- 2022/08/13 06:00 [medline]
AID - S0007125022001118 [pii]
AID - 10.1192/bjp.2022.111 [doi]
PST - aheadofprint
SO  - Br J Psychiatry. 2022 Aug 12:1-10. doi: 10.1192/bjp.2022.111.